Primary Name: Ephedra (Ephedra sinica, E. equisetina, or E. intermedia)
Other Names: Desert herb, joint fir, sea grape, teamster’s tea, yellow horse, and ma huang
Dosage: Capsule: 15 to 20 mg three times daily.
Indications/Homeopathic Use
- Weight loss
- Stimulant
- Antidepressant
- Asthma
- Athletic performance enhancement
- Bronchospasm
- Obesity
- Nasal congestion
Perioperative Concerns
Anesthesia providers are advised to avoid medications that could provoke tachycardia and hypertension in patients who have taken ephedra, due to the associated risks of myocardial ischemia and stroke. Additionally, the combination of ephedra and halothane may lead to ventricular arrhythmias. Prolonged use of ephedra can deplete the body's endogenous catecholamines, potentially resulting in hemodynamic instability during surgery. Moreover, life-threatening interactions have been reported between ephedra and monoamine oxidase inhibitors (MAOIs). It is recommended for surgical patients to stop using ephedra at least two weeks prior to surgery to mitigate the risk of adverse interactions with cardiovascular medications. Reflecting the heightened concerns about cardiovascular risks and hemodynamic instability associated with its use around the time of surgery, the sale of ephedra products was banned by the U.S. Food and Drug Administration, announced in late 2003 and effective in 2004 (Ling, 2004).
Additional Information
Ephedra contributes to weight loss by suppressing appetite and enhancing the body's metabolic rate, partly through the release of norepinephrine and activation of the hypothalamus to boost metabolism. Additionally, it activates the sympathetic nervous system, leading to increases in blood pressure, heart rate, and the strength of heart contractions, while also augmenting blood flow to the heart, brain, and muscles, and simultaneously decreasing renal and liver blood flow.
The primary active components of ephedra are flavonoids, proanthocyanidins, and alkaloids, chiefly ephedrine and pseudoephedrine. Beyond its effect on appetite, ephedra may induce side effects like nausea, vomiting, dry mouth, and bronchodilation, along with affecting the nasal mucus membranes. Significant cardiovascular effects, including hypertension, tachycardia, and peripheral vasoconstriction, are linked to its use.
